DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Dougherty, Patrick Brian	DOIID	1042989	NAIC NPN	19185822

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	6/6/2019	3/31/2021
Inactive	Non Resident	Agent	Life	6/6/2019	3/31/2021
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Health	6/6/2019	1/4/2021
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Life	6/6/2019	1/4/2021
Inactive	Great Southern Life Insurance Company	301443	Agent - Health	11/5/2019	3/31/2021
Inactive	Great Southern Life Insurance Company	301443	Agent - Life	11/5/2019	3/31/2021
Inactive	Pruco Life Insurance Company	300954	Agent - Life	9/20/2019	11/25/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Health Iq Insurance Services, Inc	882220	Agent - Life	6/19/2019	2/26/2020
Inactive	Health Iq Insurance Services, Inc	882220	Agent - Health	6/19/2019	2/26/2020